Findings on intraprocedural non-contrast computed tomographic imaging following hepatic artery embolization are associated with development of contrast-induced nephropathy

作     者：Mohamed M Soliman Debkumar Sarkar Ilya Glezerman Majid Maybody 

作者机构：Interventional Radiology ServiceMemorial Sloan Kettering Cancer CenterNew YorkNY 10065United States Department of MedicineMemorial Sloan Kettering Cancer CenterNew YorkNY 10065United States 

出 版 物：《World Journal of Nephrology》 (世界肾病学杂志（英文版）)

年 卷 期：2020年第9卷第2期

页      面：33-42页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基　　金：National Institutes of Health, NIH National Cancer Institute, NCI, (P30 CA008748) 

主　　题：Hepatic artery embolization Non-contrast computed tomographic Contrastinduced nephropathy Renal enhancement pattern Intra-arterial Renal artery calcification 

摘      要：BACKGROUND Contrast-induced nephropathy(CIN)is a reversible form of acute kidney injury that occurs within 48-72 h of exposure to intravascular contrast *** is the third leading cause of hospital-acquired acute kidney injury and accounts for 12%of such *** factors for CIN development can be divided into patientand *** former includes pre-existing chronic renal insufficiency and diabetes *** latter includes high contrast volume and repeated exposure over 72 *** incidence of CIN is relatively low(up to 5%)in patients with intact renal ***,in patients with known chronic renal insufficiency,the incidence can reach up to 27%.AIM To examine the association between renal enhancement pattern on non-contrast enhanced computed tomographic(CT)images obtained immediately following hepatic artery embolization with development of *** Retrospective review of all patients who underwent hepatic artery embolization between 01/2010 and 01/2011(n=162)was *** without intraprocedural CT imaging(n=51),combined embolization/ablation(n=6)and those with chronic kidney disease(n=21)were *** study group comprised of 84 patients with 106 *** was defined as 25%increase above baseline serum creatinine or absolute increase≥0.5 mg/dL within 72 h ***-embolization CT was reviewed for renal enhancement patterns and presence of renal artery *** association between noncontrast CT findings and CIN development was examined by Fisher’s Exact *** CIN occurred in 11/106(10.3%)procedures(Group A,n=10).The renal enhancement pattern in patients who did not experience CIN(Group B,n=74 with 95/106 procedures)was late excretory in 93/95(98%)and early excretory(EE)in 2/95(2%).However,in Group A,there was a significantly higher rate of EE pattern(6/11,55%)compared to late excretory pattern(5/11)(P0.001).A significantly higher percentage of patients that developed CIN had re